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Erschienen in: Surgery Today 10/2013

01.10.2013 | Original Article

Utilization of hospital services by obese patients before and after bariatric surgery

verfasst von: Muhammad Ali Karim, Jamil Ahmed, Clare Arneil, Abdulmajid Ali

Erschienen in: Surgery Today | Ausgabe 10/2013

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Abstract

Purpose

To compare the utility of various hospital services used by morbidly obese patients before and after bariatric surgery.

Methods

The subjects of this retrospective study were 73 consecutive patients, who underwent elective laparoscopic bariatric surgery between May 2008 and December 2010. There were 58 women and 15 men, with a median age of 45 years (IQR 26–65 years). The preoperative period ranged from 42 to 72 months (median 60 months) and the follow-up period ranged from 12 to 42 months (median 24 months). The health services analyzed included visits to emergency and outpatient departments, admissions to hospital, length of stay in hospital, and changes in regular medication before and after surgery. We also analyzed the economic results.

Results

In the post-procedure period, outpatient clinic visits were reduced by 13.8 % per year (p = 0.04), the number of hospital admissions per year were reduced by 40.2 % (p = 0.01), the total length of stay in hospital was reduced by 52.28 % per year (p = 0.04), and regular medications were reduced by 26 % (p = 0.003). There was no change in the use of emergency services. The total estimated cost saving ranged between $32,593 and 41,177 per year.

Conclusion

The utilization of various health services decreased soon after bariatric surgery, which translated into significant cost savings. This was mainly due to each patient’s reduction in body weight and improvement in their chronic metabolic disorders.
Literatur
1.
Zurück zum Zitat Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i–xii, 1–253. Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser. 2000;894:i–xii, 1–253.
2.
Zurück zum Zitat Wang YC, McPherson K, Marsh T, Gortmaker SL, Brown M. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet. 2011;378(9793):815–25.PubMedCrossRef Wang YC, McPherson K, Marsh T, Gortmaker SL, Brown M. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet. 2011;378(9793):815–25.PubMedCrossRef
3.
Zurück zum Zitat Kopelman P, Jebb SA, Butland B. Executive summary: Foresight ‘Tackling Obesities: Future Choices’ project. Obes Rev. 2007;8(Suppl 1):vi–ix. Kopelman P, Jebb SA, Butland B. Executive summary: Foresight ‘Tackling Obesities: Future Choices’ project. Obes Rev. 2007;8(Suppl 1):vi–ix.
4.
Zurück zum Zitat Avenell A, Broom J, Brown TJ, Poobalan A, Aucott L, Stearns SC, et al. Systematic review of the long-term effects and economic consequences of treatments for obesity and implications for health improvement. Health Technol Assess. 2004;8(21):iii–iv, 1–182. Avenell A, Broom J, Brown TJ, Poobalan A, Aucott L, Stearns SC, et al. Systematic review of the long-term effects and economic consequences of treatments for obesity and implications for health improvement. Health Technol Assess. 2004;8(21):iii–iv, 1–182.
5.
Zurück zum Zitat Pagotto U, Vanuzzo D, Vicennati V, Pasquali R. Pharmacological therapy of obesity. G Ital Cardiol (Rome). 2008;9(4 Suppl 1):83S–93S. Pagotto U, Vanuzzo D, Vicennati V, Pasquali R. Pharmacological therapy of obesity. G Ital Cardiol (Rome). 2008;9(4 Suppl 1):83S–93S.
6.
Zurück zum Zitat Frezza EE, Chiriva-Internati M, Wachtel MS. Analysis of the results of sleeve gastrectomy for morbid obesity and the role of ghrelin. Surgery Today. 2008;38(6):481–3.PubMedCrossRef Frezza EE, Chiriva-Internati M, Wachtel MS. Analysis of the results of sleeve gastrectomy for morbid obesity and the role of ghrelin. Surgery Today. 2008;38(6):481–3.PubMedCrossRef
7.
Zurück zum Zitat Colquitt JL, Picot J, Loveman E, Clegg AJ. Surgery for obesity. Cochrane Database Syst Rev. 2009(2):CD003641. Colquitt JL, Picot J, Loveman E, Clegg AJ. Surgery for obesity. Cochrane Database Syst Rev. 2009(2):CD003641.
8.
Zurück zum Zitat Christou NV, Sampalis JS, Liberman M, Look D, Auger S, McLean AP, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg. 2004;240(3):416–23.PubMedCrossRef Christou NV, Sampalis JS, Liberman M, Look D, Auger S, McLean AP, et al. Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients. Ann Surg. 2004;240(3):416–23.PubMedCrossRef
9.
Zurück zum Zitat Sjostrom L, Narbro K, Sjostrom CD, Karason K, Larsson B, Wedel H, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.PubMedCrossRef Sjostrom L, Narbro K, Sjostrom CD, Karason K, Larsson B, Wedel H, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.PubMedCrossRef
10.
Zurück zum Zitat Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357(8):753–61.PubMedCrossRef Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, et al. Long-term mortality after gastric bypass surgery. N Engl J Med. 2007;357(8):753–61.PubMedCrossRef
11.
Zurück zum Zitat Sugerman HJ, Sugerman EL, DeMaria EJ, Kellum JM, Kennedy C, Mowery Y, et al. Bariatric surgery for severely obese adolescents. J Gastrointest Surg. 2003;7(1):102–7.PubMedCrossRef Sugerman HJ, Sugerman EL, DeMaria EJ, Kellum JM, Kennedy C, Mowery Y, et al. Bariatric surgery for severely obese adolescents. J Gastrointest Surg. 2003;7(1):102–7.PubMedCrossRef
12.
Zurück zum Zitat Buchwald H, Estok R, Fahrbach K, Banel D, Jensen MD, Pories WJ, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122(3):248–56.PubMedCrossRef Buchwald H, Estok R, Fahrbach K, Banel D, Jensen MD, Pories WJ, et al. Weight and type 2 diabetes after bariatric surgery: systematic review and meta-analysis. Am J Med. 2009;122(3):248–56.PubMedCrossRef
13.
Zurück zum Zitat Ashrafian H, le Roux CW, Rowland SP, Ali M, Cummin AR, Darzi A, et al. Metabolic surgery and obstructive sleep apnoea: the protective effects of bariatric procedures. Thorax. 2012;67(5):442–9.PubMedCrossRef Ashrafian H, le Roux CW, Rowland SP, Ali M, Cummin AR, Darzi A, et al. Metabolic surgery and obstructive sleep apnoea: the protective effects of bariatric procedures. Thorax. 2012;67(5):442–9.PubMedCrossRef
14.
Zurück zum Zitat Picot J, Jones J, Colquitt JL, Gospodarevskaya E, Loveman E, Baxter L, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13(41):1–190, 215–357. Picot J, Jones J, Colquitt JL, Gospodarevskaya E, Loveman E, Baxter L, et al. The clinical effectiveness and cost-effectiveness of bariatric (weight loss) surgery for obesity: a systematic review and economic evaluation. Health Technol Assess. 2009;13(41):1–190, 215–357.
15.
Zurück zum Zitat Barreto Villela N, Braghrolli Neto O, Lima Curvello K, Eduarda Paneili B, Seal C, Santos D, et al. Quality of life of obese patients submitted to bariatric surgery. Nutr Hosp. 2004;19(6):367–71.PubMed Barreto Villela N, Braghrolli Neto O, Lima Curvello K, Eduarda Paneili B, Seal C, Santos D, et al. Quality of life of obese patients submitted to bariatric surgery. Nutr Hosp. 2004;19(6):367–71.PubMed
16.
Zurück zum Zitat Karlsson J, Taft C, Ryden A, Sjostrom L, Sullivan M. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes. 2007;31(8):1248–61.CrossRef Karlsson J, Taft C, Ryden A, Sjostrom L, Sullivan M. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes. 2007;31(8):1248–61.CrossRef
17.
Zurück zum Zitat Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.PubMedCrossRef Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.PubMedCrossRef
18.
Zurück zum Zitat Sampalis JS, Liberman M, Auger S, Christou NV. The impact of weight reduction surgery on health-care costs in morbidly obese patients. Obes Surg. 2004;14(7):939–47.PubMedCrossRef Sampalis JS, Liberman M, Auger S, Christou NV. The impact of weight reduction surgery on health-care costs in morbidly obese patients. Obes Surg. 2004;14(7):939–47.PubMedCrossRef
19.
Zurück zum Zitat Ghiassi S, Morton J, Bellatorre N, Eisenberg D. Short-term medication cost savings for treating hypertension and diabetes after gastric bypass. Surg Obes Relat Dis. 2012;8(3):269–74.PubMedCrossRef Ghiassi S, Morton J, Bellatorre N, Eisenberg D. Short-term medication cost savings for treating hypertension and diabetes after gastric bypass. Surg Obes Relat Dis. 2012;8(3):269–74.PubMedCrossRef
20.
Zurück zum Zitat Cremieux PY, Buchwald H, Shikora SA, Ghosh A, Yang HE, Buessing M. A study on the economic impact of bariatric surgery. Am J Manag Care. 2008;14(9):589–96.PubMed Cremieux PY, Buchwald H, Shikora SA, Ghosh A, Yang HE, Buessing M. A study on the economic impact of bariatric surgery. Am J Manag Care. 2008;14(9):589–96.PubMed
21.
Zurück zum Zitat Sussenbach SP, Padoin AV, Silva EN, Benzano D, Pufal MA, Barhouch AS, et al. Economic benefits of bariatric surgery. Obes Surg. 2012;22(2):266–70.PubMedCrossRef Sussenbach SP, Padoin AV, Silva EN, Benzano D, Pufal MA, Barhouch AS, et al. Economic benefits of bariatric surgery. Obes Surg. 2012;22(2):266–70.PubMedCrossRef
22.
Zurück zum Zitat Von Lengerke T, John J, KORA Study Group. Excess use of general practitioners by obese adults: does health-related quality of life account for the association? Psychol Health Med. 2007;12(5):536–44.CrossRef Von Lengerke T, John J, KORA Study Group. Excess use of general practitioners by obese adults: does health-related quality of life account for the association? Psychol Health Med. 2007;12(5):536–44.CrossRef
Metadaten
Titel
Utilization of hospital services by obese patients before and after bariatric surgery
verfasst von
Muhammad Ali Karim
Jamil Ahmed
Clare Arneil
Abdulmajid Ali
Publikationsdatum
01.10.2013
Verlag
Springer Japan
Erschienen in
Surgery Today / Ausgabe 10/2013
Print ISSN: 0941-1291
Elektronische ISSN: 1436-2813
DOI
https://doi.org/10.1007/s00595-013-0540-6

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